RT Journal Article
T1 Modifiable Risk Factors and Trends in Changes in Glucose Regulation during the First Three Years Postdelivery: The St Carlos Gestational Diabetes Mellitus Prevention Cohort
A1 Arnoriaga Rodríguez, María
A1 Melero, Verónica
A1 Barabash Bustelo, Ana
A1 Valerio, Johanna
A1 Valle, Laura del
A1 Martín O'Connor, Rocío
A1 De Miguel Novoa, María De La Paz
A1 Díaz Pérez, José Ángel
A1 Familiar, Cristina
A1 Moraga, Inmaculada
A1 Durán Rodríguez-Hervada, Alejandra
A1 Jiménez, Inés
A1 Cuesta, Martín
A1 Torrejón, María José
A1 Martínez-Novillo González, Mercedes
A1 Runkle De La Vega, Isabel Ana
A1 Pazos, Mario
A1 Rubio Herrera, Miguel Ángel
A1 Matía Martín, María Del Pilar
A1 Calle Pascual, Alfonso Luis
AB Objective: Evaluation of the influence of potential risk factors (RFs) on glycemic changes at 3 years postpartum. Methods: The glycemic status of 1400 women, in absence of a new pregnancy, was evaluated at 3 months (3 m) and 3 years (3 y) postpartum, after participation in the St. Carlos Gestational Study (2228 normoglycemic pregnant women followed from before gestational week 12 to delivery, from 2015–2017). Abnormal glucose regulation (AGR) was defined as fasting serum glucose ≥ 100 mg/dL and/or HbA1c ≥ 5.7% and/or 2 h 75 g OGTT glucose ≥ 140 mg/dL. In total, 12 modifiable and 3 unmodifiable RFs were analyzed. Results: 3 m postpartum, 110/1400 (7.9%) women had AGR; 3 y postpartum, 137 (9.8%) women exhibited AGR (110 with 3 m normal glucose tolerance [NGT]); 1263 (90.2%) had NGT (83 with 3 m AGR). More women with gestational diabetes mellitus (GDM) progressed to AGR at 3 y (OR: 1.60 [1.33–1.92]) than women without GDM. Yet, most women with 3 m and/or 3 y AGR had no GDM history. Having ≥2 unmodifiable RFs was associated with increased risk for progression to AGR (OR: 1.90 [1.28–2.83]) at 3 y postpartum. Having >5/12 modifiable RFs was associated with increased progression from NGT to AGR (OR: 1.40 [1.00–2.09]) and AGR persistence (OR: 2.57 [1.05–6.31]). Pregestational BMI ≥ 25 kg/m2 (OR: 0.59 [0.41–0.85]), postdelivery weight gain (OR: 0.53 [0.29–0.94]), and waist circumference > 89.5 cm (OR: 0.54 [0.36–0.79]) reduced the likelihood of NGT persisting at 3 y. Conclusions: 3-month and/or 3-year postpartum AGR can be detected if sought in women with no prior GDM. Modifiable and unmodifiable RF predictors of AGR at 3 y postpartum were identified. Universal screening for glycemic alterations should be considered in all women following delivery, regardless of prior GDM. These findings could be useful to design personalized strategies in women with risk factors for 3 y AGR.
PB MDPI
YR 2023
FD 2023-12-01
LK https://hdl.handle.net/20.500.14352/103911
UL https://hdl.handle.net/20.500.14352/103911
LA eng
NO Arnoriaga-Rodriguez, M.; Melero, V.; Barabash, A.; Valerio, J.; del Valle, L.; O’Connor, R.M.; de Miguel, P.; Diaz, J.A.; Familiar, C.; Moraga, I.; et al. Modifiable Risk Factors and Trends in Changes in Glucose Regulation during the First Three Years Postdelivery: The St Carlos Gestational Diabetes Mellitus Prevention Cohort. Nutrients 2023, 15, 4995. https://doi.org/10.3390/ nu15234995
NO Author Contributions: M.A.-R., A.B., A.L.C.-P., A.D., P.M.-M., M.A.R., P.d.M., J.A.D., L.d.V., V.M., J.V., I.R., M.P. and R.M.O. were involved in conceptualization and design, data curation, analysis, and interpretation of data. A.L.C.-P. was responsible for funding acquisition. A.L.C.-P., C.F., I.M., I.J., M.A.-R., M.J.T., M.M.-N., M.P., A.D., P.d.M., A.B., L.d.V., V.M., J.V. and R.M.O. were involved in supervision, validation, and visualization of researched data, and contributed to discussion and investigation. M.C., M.P., P.M.-M., M.A.-R. and M.A.R. were involved in data research and reviewed and edited the manuscript. Writing—original draft: A.L.C.-P., M.A.-R., V.M., I.R. and P.M.-M. wrote the first draft of the manuscript. Writing—review & editing: M.A.-R., A.L.C.-P., P.M.-M., V.M., and I.R. A.L.C.-P. is the guarantor of this work and, as such, had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. All authors have read and agreed to the published version of the manuscript.
NO Ministerio de Ciencia, Innovación y Universidades (España)
DS Docta Complutense
RD 1 sept 2024